GREENEVILLE – Many patients who come to Takoma Regional Hospital’s emergency department think they are having a heart attack.

Fortunately, only a few of them are correct.

“A lot of other conditions can feel like a heart attack,” said Dr. Martin Schnell, medical director of Takoma Regional’s emergency department. “But the rule of thumb is, if you are in doubt, come to the ER. It’s better to be safe than sorry.”

It is reasonable for someone with chest pain to wait up to five minutes to see if the discomfort might just be indigestion, Dr. Schnell said.

“But if the pain persists beyond a few minutes, they need to come on in, especially if the pain gets worse,” he said.

Chances are greater for a heart attack if risk factors exist, but even those without risk factors have been known to suffer a heart attack.

“Risk factors can include diabetes, a family history of heart disease, smoking, high blood pressure and high cholesterol,” Dr. Schnell said.

It’s important to learn the difference between heart attack symptoms and other conditions. Knowing the difference could save your life.

Here’s what you need to know about the imposters:

• Heartburn – Heartburn is a symptom that occurs after eating or while lying down or bending over. It starts with a burning sensation that may begin in your upper abdomen and radiate to your neck. Heartburn can be brief or last for hours. You might even have a sour taste in your mouth from stomach acid that can back up into the esophagus. Certain foods such as spicy or acidic foods and too much alcohol or caffeine can cause heartburn.

• Esophageal muscle spasms – A muscle spasm in the esophagus can have the same effect as heartburn or even mimic a heart attack.

• Gallbladder attack – The pain of a gallbladder attack can spread to your chest and cause nausea and an intense, steady pain in the upper middle or upper right abdomen – especially after a fatty meal. The pain can even spread to your shoulders, neck or arms.

A real heart attack requires immediate attention. Some come suddenly and intensely – where no one doubts what is happening. But most heart attacks start slowly, with mild pain or discomfort. Often people aren’t sure what’s wrong and wait too long before getting help, Dr. Schnell said.

Here are signs of a heart attack:

• Chest discomfort Discomfort in the center of the chest that lasts more than a few minutes or goes away and comes back; sometimes described as pressure, squeezing, fullness or pain

• Upper body discomfort – Pain in one or both arms, the back, neck, jaw or stomach

• Shortness of breath – With or without chest discomfort

• Other signs – Breaking out in a cold sweat, nausea or lightheadedness

Both men and women can suffer chest pain or discomfort during a heart attack, Dr. Schnel said. Women and those with diabetes are more likely to experience the other common symptoms, including shortness of breath, sweating, nausea and jaw/arm pain. Atypical symptoms include vomiting, back pain or generalized weakness.

A real heart attack can be diagnosed with the help of several tests, Dr. Schnell said. After reviewing a patient’s complete medical history and giving a physical examination, an electrocardiogram will be ordered to discover any abnormalities caused by damage to the heart, Dr. Schnell said.

“And, we also use a blood test to detect abnormal levels of heart enzymes in the bloodstream,” he said.